People’s Inquiry – a grassroots vision for our NHS?

Normal
0
false
false
false
EN-US
JA
X-NONE

As the NHS groans under cuts and chaotic reorganisation, government bodies are calling for yet more 'radical change' and 'difficult decisions'. Will their answers be hospital closures and privatisations? The new People's Inquiry is calling for evidence to support a different way forward.

Share this

Read more!

Get our weekly email

Enter your email address

Campaigners fighting hospital closures, cutbacks and the
erosion of mental health and other services have years of bitter experience of
presenting solid, evidence-based arguments in “consultations” that ignore them
and press ahead regardless. I know. In almost 30 years, I’ve been there with
them too many times.

So the chance to outline the campaigners’ case to an
independent Panel in a series of public hearings on the
developing crisis in London is a really useful opportunity to focus attention
once again on the issues and arguments that in any genuine debate would have
won the day, or at least forced a serious reply.

The Peoples Inquiry
is a bold initiative funded by Unite the Union, but open to all those who want
to take part. It will formulate a report on London’s NHS to be published in the
new year. This will be a resource for campaigners, a tool to persuade
politicians, and a pressure on those forcing through controversial proposals in
the teeth of local opposition.

It’s a genuine effort to piece together the jigsaw, and develop
a picture of the NHS in London, and kick-start fresh debate on how it should
proceed.

This is no phony NHS “consultation”:
we really hope to reach out on the widest possible basis.

The Panel’s task is to bring together verbal and written
evidence and piece together a picture of the situation shaping up in the NHS
right across London. It’s chaired by NHS
commentator Roy Lilley, and includes the Guardian’s Polly Toynbee, alongside
campaigners and union activists.

But many campaigners have become too used to having their
views brushed aside: too used to having to hold their own public meetings as
the only platform to allow their opposition to be discussed – and the idea of
formulating their arguments as evidence may seem strange.

There’s no fixed formula. The shape of each verbal
submission will vary according to the issue. But in each case the point to
focus on is that the Inquiry is trying to get an idea of not only the facts and
figures of what’s happening, many of which can be gleaned from published
sources, but also as far as possible at the impact of changes and cutbacks – on patients, their families,
communities and health workers.

Personal stories,
accounts of what it feels like for staff on the frontline and patients who
depend upon threatened services will be very effective.

The Inquiry will also be asking CCGs and NHS Trusts and
Foundations to set out their view, so the more hard evidence there is of the human
impact, the better these accounts can be put into perspective. Written evidence
is also welcome, where necessary this can be submitted anonymously online.

The Inquiry is also very keen to go beyond the obvious
issues of hospital cuts and closures – to discuss mental health, the
interaction of NHS with social care, and wider issues, knowing there are few,
if any, big issues in the NHS that are not unfolding in London.

Three years of frozen pay for NHS staff, at a time of rising
inflation, have effectively cut the value of wages by 12
percent, exacerbating recruitment problems in many London hospitals as
housing costs continue to rise in the capital; the result – rising Trust
spending on agency staff. But the government wants even deeper cuts in pay and
conditions for NHS staff.

NHS budgets, too have been effectively frozen, with only the
most microscopic real terms increase since 2010, making 2010-2014 the meanest-ever
five years for NHS funding – while pressures on NHS budgets increase costs
by an average 4% annually.

In the quest for cuts, a detailed map of the capital in NHS
London’s “Integrated
Strategic Plan 2010-2015” in January 2010showed that in 23 out of 40 hospital sites the future
was undecided, and two hospitals were already due to lose most of their acute
inpatient and all of their emergency services.

But from the beginning the proposed reductions in hospital
care and “shift of activity” to supposedly “lower cost settings” have been
detached from any concrete plans for expansion
of community services and primary care to take the additional
workload. Plans to replace A&E units
with Urgent Care Centres are based on highly
contested assumptions. And while the
focus has been on acute services, mental
health care in the capital is also under growing strain.

London’s boroughs, too, and the social care they are
supposed to provide, have been subjected to a continual
cash squeeze, reducing services in many areas restricted only to those with
the most serious needs, while others are left to cope alone. The result? Ever-rising
use of emergency NHS services.

Add to this mix the organisational chaos brought by the Health & Social Care Act
which scrapped the existing commissioners, broke up NHS London, carving
the capital into three, and dumped responsibility for huge budgets onto Clinical
Commissioning Groups (CCGs) supposedly led by GPs, while giving real control to
shadowy Commissioning Support Units.

With untested CCG leaderships, implementing unproven ideas,
the situation is now further confused by the requirement to open up a growing
range of services to competitive
tender, with competition rules preventing GPs from taking back control of
Out of Hours services, and obstructing mergers
of hospital trusts.

Control of specialist services is now in the hands not of
Clinical Commissioning Groups, but NHS England, whose disruptive intervention in
London has already undermined quality care, with the switch of a “gamma knife”
contract from the existing highly-skilled team at UCLH to private providers at Barts
and the BUPA Cromwell Hospital.

London was the first area to face the draconian powers of
the “unsustainable provider regime,” used to tackle the growing deficits at
South London Healthcare Trust – leading to a £1 billion package that included
brutal cuts at the neighbouring Lewisham Hospital, which have since been overturned by a
judicial review.

At the centre of the South London Healthcare meltdown were
two disastrously over-priced Private Finance Initiative schemes, which built
hospitals worth £210 million but which will cost £2.3 billion or more. These
are not the biggest or the worst PFI schemes, and
others in the capital can now be seen triggering cuts and chaos – notably the
£300m Queens Hospital in Romford and the £1 billion Barts and
Royal London scheme which is now forcing cuts in the country’s biggest Trust,
Barts Health.

Barts and other cash-strapped Trusts have turned to staffing
cuts, scaling back numbers of senior
nurses – who are key to maintaining quality patient care.

The stories go on.

But NHS London has been now scrapped. Most of the records of
its activity since 2009 are in obscure archives on the British Library website.

With no unifying body to keep track of changes or stand up
for health care in Europe’s biggest city, the Peoples Inquiry is trying to
uncover the true picture.

We hope campaigners will take the chance to respond. Right
now, almost nobody else is listening. Let’s make them.

Comments

Related

This article is published under a Creative Commons
Attribution-NonCommercial 4.0 International licence. If you have any
queries about republishing please
contact us.
Please check individual images for licensing details.